MEDICARE: NEW BRAUNFELS OB GYN PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	L8486	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0046MA	OTHER	TX	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346421807
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW BRAUNFELS OB GYN PA

Provider Business Mailing Address
First Line	:	2115 STEPHENS PL
Second Line	:	SUITE 1210
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-2132
Country	:	US
Telephone Number	:	830-626-6810
Fax Number	:	830-629-5001

Provider Business Practice Location Address
First Line	:	2115 STEPHENS PL
Second Line	:	SUITE 1210
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-2132
Country	:	US
Telephone Number	:	830-626-6810
Fax Number	:	830-629-5001

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NAGAKRISHNA REDDY
Credential	:	MD
Telephone Number	:	830-626-6810

Provider Enumeration Date	:	11/26/2007
Last Update Date	:	07/21/2014

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Directions to “NEW BRAUNFELS OB GYN PA ” Practice Location

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